For those attending, you can obtain the Merlin eBook about Proofs of Loss.

Tropical Storm Cristobal is predicted be a major flood event:

Cristobal is forecast to re-emerge over the southern Gulf of Mexico on Friday and move northward over the central and northern Gulf of Mexico over the weekend. There is a risk of tropical storm force winds this weekend from Louisiana to the western Florida Panhandle and a risk of dangerous storm surge from Louisiana to the Florida Big Bend. These hazards will arrive well in advance of and extend well east of Cristobal’s center. Storm surge and tropical storm watches will likely be issued for a portion of the U.S. Gulf Coast on Friday.

It will strike areas which are routinely flooded by similar past storms. Accordingly, we will have an in-depth discussion reminding everybody about the exacting content and time requirements the National Flood Program places on Proofs of Loss. A national flood proof of loss is unlike any other and many claims are ruined by the failure to properly submit one.

Corey and I were successfully involved in a case which involved the two-year requirement contained in many law and ordinance coverage provisions. We won arguing that forfeitures of coverage are not favored in the law. The court stated:

Florida law abhors forfeitures. As a result, [i]f an insurer intends to stand on any forfeiture reservation, it should inform the insured as soon as practicable after it has ascertained facts upon which it bases its forfeiture. It is equally well established that when an insurer has knowledge of the existence of facts justifying a forfeiture of the policy, any unequivocal act which recognizes the continued existence of the policy or which is wholly inconsistent with a forfeiture, will constitute a waiver.1

The punishment does not fit the crime. Forfeiture is a draconian, anachronistic, archaic, and profoundly anti-consumer sanction. Outside insurance law, “hornbook” remedies for breach of contract no longer include forfeiture, if indeed they ever did. Forfeiture is mentioned in most contexts only in connection with a discussion of agreed contractual remedies, such as liquidated damages or specific performance, and even then it is often described as an unenforceable penalty.

We will talk about forfeitures in the context of proofs of loss and how non-forfeiture should apply to other clauses and benefits in the insurance contract. Hope you can join us later this afternoon for the discussion. Here is the link.

1. An assemblage of three or more persons in a public place taking concerted action in a turbulent and disorderly manner for a common purpose (regardless of the lawfulness of that purpose).

2. An unlawful disturbance of the peace by an assemblage of usually three or more persons acting with a common purpose in a violent or tumultuous manner that threatens or terrorizes the public or an institution.

Courts have defined riots differently. For example, it has been defined as ‘the gathering of three or more persons’ with the ‘common purpose’ to do ‘an unlawful act [with the intent to use] force or violence.’1 It has also been defined as requiring ‘tumult” or disturbance’ at the time of the action.2

A civil commotion is defined as a public uprising by a large number of people who, acting together, cause harm to people or property.3

The Second District Court of Appeal has compared the terms riot and civil commotion:4

• The local nature of the perils of ‘riot’ or ‘civil commotion’ imparts occasional local or temporary outbreaks of unlawful violence.

• Riots and civil commotion are purely ‘domestic disturbances.’

• They are ‘essentially a kind of domestic disturbance. . . such as occur among fellow citizens or within the limits of one community.’

• In order for a disturbance to qualify as civil commotion, ‘the agents causing the disorder must gather together and cause a disturbance and tumult.’

The commonly understood meaning of the term…includes public disturbance or tumult as an essential element. Vandalism, arson or other such acts, destructive as they may be, do not constitute a riot if they are conducted away from public view with the intent they remain unobserved.

The dissenting opinion is worth reading in its entirety because it states how insurance policies should be interpreted to find coverage under California law:

[A]ny ambiguity or uncertainty in an insurance policy is to be resolved against the insurer and … if semantically permissible, the contract will be given such construction as will fairly achieve its object of providing indemnity for the loss to which the insurance relates. The purpose of this canon of construction is to protect the insured’s reasonable expectation of coverage in a situation in which the insurer-draftsman controls the language of the policy. Its effect differs, depending on whether the language to be construed is found in a clause providing coverage or in one limiting coverage. Whereas coverage clauses are interpreted broadly so as to afford the greatest possible protection to the insured, exclusionary clauses are interpreted narrowly against the insurer. [A]n insurer cannot escape its basic duty to insure by means of an exclusionary clause that is unclear. As we have declared time and again, any exception to the performance of the basic underlying obligation must be so stated as clearly to apprise the insured of its effect; thus, the burden rests upon the insurer to phrase exceptions and exclusions in clear and unmistakable language. (Citations omitted)

It further explains arguments for “riot” coverage:

An ambiguity exists when the written language of an instrument is susceptible of two or more interpretations….My colleagues claim neither party argues the term ‘riot’ is ambiguous, and the term as understood by the layman is unambiguous. I totally disagree.

There are as many as 14 definitions of the word ‘riot’ in The Random House Dictionary of the English Language. Although the majority of these definitions are inapplicable to the facts in this case, I find three definitions which provide possible interpretations of the contract language: ‘1. a noisy, violent public disorder caused by a group or crowd of persons, … 2. Law. a disturbance of the public peace by three or more persons acting together in a disrupting and tumultuous manner in carrying out their private purposes. 3. violent or wild disorder or confusion.’ (The Random House Dict., op. cit. supra.) Each of these definitions provides a somewhat different set of circumstances. While two of the definitions require the event to occur in public, the third does not. Thus, the word ‘riot’ is capable of being understood in two or more possible ways and is ambiguous.

Both North Bay and the Insurers rely on Penal Code section 404 to define the word ‘riot,’ although they arrive at different interpretations. However, the mere fact that the Legislature has defined a term for one purpose does not shelter that word from the normal rules of interpretation. Penal Code section 404 defines ‘riot’ for the purpose of criminal law; the statute was not intended for construing insurance contracts. Here, the language is that of the insurer, not of the Legislature, and the normal rules of interpretation apply….

It is for this reason I reject the Insurers’ authorities from other jurisdictions….In each of these cases the court looked to either a state statute or the common law, which defined ‘riot’ for the purpose of criminal law. While the criminal definition of ‘riot” provides a possible interpretation of the disputed term, there are other definitions for “riot’ which do not constitute criminal conduct.

I also question the majority’s position that the definition of ‘riot’ necessarily connotes activity that is done in public and before witnesses, and that it does not include conduct that is surreptitious. The unfortunate events which occurred in Los Angeles in April of this year highlight my concerns. If, for example, two Los Angeles retail stores have the same insurance policy as the one in this case, is only that store which is torched and looted before witnesses covered under the policy? Would any damage caused by an act of vandalism or arson during the three-night period be uncovered?

My view that the term ‘riot’ is ambiguous is further supported by the fact that, according to language in the insurance policy, single losses occurring during a 72–hour period include ‘riot’ and ‘riot attending a strike or civil commotion.’ If the term ‘riot’ was unambiguous, there would be no need for this redundancy. The majority’s distinction between ‘riot’ and ‘riot attending a strike or civil commotion’ is contradicted by the policy. Windstorms, hail, riots and riots attending a strike or civil commotion are all contemplated as prolonged disturbances which may occur for more than 72 hours.

The bottom line is that some insurance companies look for more ways not to pay than for reasons of coverage. While “riots” and “civil commotion” seem to be the cause for many recent damages which should result in coverage, those ingenious insurance company attorneys will often argue the fine print and definitions to prevent commercial policyholders from receiving coverage for events which may not just catch the public eye on television because they were done in non-public area, which just happens to be by a nearby riot or civil commotion. How absurd!

This is wrong and Merlin Law Group is here to help if you are caught with an insurance company not willing to Pay Up!

]]>https://www.propertyinsurancecoveragelaw.com/2020/06/articles/insurance/what-exactly-is-a-riot-and-civil-commotion-under-a-property-insurance-policy/feed/0Are Damages to Businesses from the Recent Riots and Civil Commotion Covered Under Property Insurance Policies?https://www.propertyinsurancecoveragelaw.com/2020/06/articles/insurance/are-damages-to-businesses-from-the-recent-riots-and-civil-commotion-covered-under-property-insurance-policies/
https://www.propertyinsurancecoveragelaw.com/2020/06/articles/insurance/are-damages-to-businesses-from-the-recent-riots-and-civil-commotion-covered-under-property-insurance-policies/#respondTue, 02 Jun 2020 17:57:59 +0000https://www.propertyinsurancecoveragelaw.com/?p=26756Continue Reading]]>Damages from the recent riots, including fire, vandalism and theft, are covered under property insurance policies. I have been receiving calls from the media and others asking me questions about insurance coverage for these sad and unfortunate events. I think a Los Angeles Times article, Is Looting Covered by Insurance? Depends on The Business, may be the cause of the confusion.

Under modern all risk insurance policies, all risks of loss, except those which are specifically excluded, are covered under the policy. Riots and Civil commotion are not excluded and indeed, they usually are specifically named perils under most commercial policies.

For example, the basic causes of loss form CP 10 10 specifically provides coverage for the following named perils:

Because of civil disturbances in scattered areas of Dade County in May, 1980, a large area of the county was designated a riot zone. Vehicular and pedestrian traffic into those areas was restricted or prohibited and county directives required the closing of all liquor stores and service stations in the designated zone. Appellee’s liquor store was within the geographical zone designated as a riot area.

In the early hours of May 20, 1980 thieves broke into appellee’s business premises. A sledge hammer was used to remove a two-foot section of concrete block at the rear of the building. The perpetrators took only the most expensive brands of liquors. The crime was reported to the police at approximately 6:00 a. m. In his report, the investigating officer concluded that the theft was a burglary, describing the modus operandi in police jargon as a ‘wall job.’

The majority of the court curiously held that the jury had to determine whether the loss was caused by a covered “riot” rather than an excluded “burglary.” The dissenting judge noted the following, citing a number of cases to the opposite:

I fail to understand how it can be said that a theft, which occurred within an area designated by police as a riot area, does not fall within the coverage of riot insurance, especially when the riot conditions required all of the stores in the area to close and to evacuate their personnel. Although some police protection remained, it is noteworthy that the burglary occurred at the store during the period the owner was forced to remain away and between police inspections.

The answer to the title question is usually “yes.” It does not depend upon the type of business as suggested by the Los Angeles Times, but upon the exact wording of the business policy purchased. As regular readers to this blog know, follow the rule of RTFP—Read The Full Policy.

]]>https://www.propertyinsurancecoveragelaw.com/2020/06/articles/insurance/are-damages-to-businesses-from-the-recent-riots-and-civil-commotion-covered-under-property-insurance-policies/feed/0Insurance Industry Responses to Covid-19 and Proofs of Losshttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/insurance-industry-responses-to-covid-19-and-proofs-of-loss/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/insurance-industry-responses-to-covid-19-and-proofs-of-loss/#respondFri, 29 May 2020 14:26:00 +0000https://www.propertyinsurancecoveragelaw.com/?p=26744Continue Reading]]>Want to learn a lot about how to handle and what to do with business income loss claims arising from the shut down of American business from Covid-19? Come listen to Amy Bach and I starting today at 12:30. So many attorneys and public adjusters are signing up claims and then asking me—“Chip, what do I do next with these claims? How do I determine if there is coverage? Should I file a lawsuit? What do I need to do before filing a lawsuit? Are there going to be class actions?”

These questions and a lot more are going to be discussed at these two very different discussions today. I would not miss them if you intend sign up these clients and represent policyholders.

Want one example of why you cannot afford to miss these “how to do it” seminars? I read one of the recently filed lawsuits—there are at least 350 of them just filed in federal court–for a business income loss against Lloyds. The allegation for the denial was that the policyholder called his agent to report the loss and the policyholder’s agent said, “the insurer will not honor the claim.” Insurance company attorneys have written all kinds of reasons why there is no coverage for these losses, but they have not been writing about how they are going to slay those who fail to comply with other conditions of the policy. Notice of loss to the insurer is a must. In this instance, there was no notice to the insurer. The agent is the agent of the policyholder because Lloyds is a surplus lines insurer and has a different agent. Even if some crazy theory of waiver or estoppel is going to be used to get around the notice argument, what happens when the proof of loss is not filed? This policy required it to be filed 60 days after the loss occurred—this was not a demand proof of loss.

I am certain many not regularly practicing field of law are asking—“what is a demand proof of loss?”

Insurance company counsel are not going to miss these defenses. They raise them all the time.

You can register for the in depth pandemic litigation seminar with Amy Bach and myself at this link. It starts today at 12:30 EST. It is sponsored by Trail Guides and will cost a small amount. I donated my royalties to United Policyholders.

Corey Harris and myself will present our third discussion in a series about proofs of loss at 3 PM EST. I will incorporate some of the ‘what to do” proof issues for compliance for the pandemic cases and here is that link.

Thought For The Day

We are all born ignorant, but one must work hard to remain stupid.

-Benjamin Franklin

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/insurance-industry-responses-to-covid-19-and-proofs-of-loss/feed/0Rene Sigman Named to Working Group for Pandemic Litigation Discovery Protocolshttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/rene-sigman-named-to-working-group-for-pandemic-litigation-discovery-protocols/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/rene-sigman-named-to-working-group-for-pandemic-litigation-discovery-protocols/#respondThu, 28 May 2020 17:21:46 +0000https://www.propertyinsurancecoveragelaw.com/?p=26739Continue Reading]]>Merlin Law Group attorney Rene Sigman has been appointed to a working group for Pandemic Litigation Discovery Protocols by the Institute for the Advancement of the American Legal System.

In a press release the IAALS stated:

Through the Initial Discovery Protocols for COVID-19 Insurance Claims project, IAALS is creating pattern protocols that will require both businesses and their insurance companies to automatically disclose certain information and documents early in the case. This will make the discovery process—normally one of the most expensive, contentious, and lengthy parts of litigation—far more efficient and targeted. The IAALS protocols will provide judges and courts with a new pretrial procedure to follow, which will make it easier and faster for the parties and their counsel to:

• Exchange important information and documents early in the case;
• Frame the issues to be resolved;
• Value the claims for possible early resolution; and
• Plan for more efficient and targeted subsequent formal discovery, if needed.

Rene Sigman is part of an impressive group of attorneys who have been selected. Steve Badger and his law firm have certainly been leaders for the insurance industry’s perspective on the pandemic litigation. Adam Levitt is an extraordinary plaintiff’s class action attorney. I was on a phone call with him a couple of weeks ago analyzing these cases. Joyce Wang is a respected West Coast property insurance defense attorney I have known for over 20 years.

Making discovery efficient and helping judges better understand the complex nature of insurance disaster litigation is something all attorneys in this field of law should strive to do. Access to justice for many less affluent policyholders requires streamlined but pointed discovery to issues which are at the heart of litigation. I am certain that this distinguished panel of attorneys and jurists will help make the current litigation faster, more relevant, and less costly for all.

Thought For The Day

At his best, man is the noblest of all animals; separated from law and justice he is the worst.—Aristotle

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/rene-sigman-named-to-working-group-for-pandemic-litigation-discovery-protocols/feed/0Kelly Kubiak and Examinations Under Oathhttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/kelly-kubiak-and-examinations-under-oath/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/kelly-kubiak-and-examinations-under-oath/#respondTue, 26 May 2020 13:27:47 +0000https://www.propertyinsurancecoveragelaw.com/?p=26697Continue Reading]]>Kelly Kubiak is one of Merlin Law Group’s most successful attorneys. She and I will discuss the examination under oath on a free livestream at 2 pm.

The United States Supreme Court long ago remarked on the purpose of the Examination Under Oath:

The object of the provisions in the policies of insurance, requiring the assured to submit himself to an examination under oath … was to enable the company to possess itself of all knowledge, and all information as to other sources and means of knowledge, in regard to the facts, material to their rights, to enable them to decide upon their obligations, and to protect them against false claims. And every interrogatory that was relevant and pertinent in such an examination was material, in the sense that a true answer to it was of the substance of the obligation of the assured.1

We will also go over practical aspects about examinations under oath (EUO) which get raised every time an insurer demands a policyholder attend such an examination. An EUO is an important and formal event which can determine if the claim is going to be paid or litigation will result.

Open-minded people tend to be interested in Buddhism because Buddha urged people to investigate things – he didn’t just command them to believe.—Dalai Lama
_________________________________1Claflin v. Commonwealth Ins. Co., 110 U.S. 81, 94-95 (1884).2Adjusting Today is published as a public service by Adjusters International, Inc.

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/kelly-kubiak-and-examinations-under-oath/feed/0Memorial Day and The War Clause in Property Insurance Policeshttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/memorial-day-and-the-war-clause-in-property-insurance-polices/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/memorial-day-and-the-war-clause-in-property-insurance-polices/#respondMon, 25 May 2020 13:33:42 +0000https://www.propertyinsurancecoveragelaw.com/?p=26690Continue Reading]]>Memorial Day is a special time to remember those men and women who have given their lives during service in our country’s military. A History Channel has this note about the beginning of this special holiday:

In May 1868, General John A. Logan, the commander-in-chief of the Union veterans’ group known as the Grand Army of the Republic, issued a decree that May 30 should become a nationwide day of commemoration for the more than 620,000 soldiers killed in the recently ended Civil War. On Decoration Day, as Logan dubbed it, Americans should lay flowers and decorate the graves of the war dead ‘whose bodies now lie in almost every city, village and hamlet churchyard in the land.’

….

After the war Logan, who had served as a U.S. congressman before resigning to rejoin the army, returned to his political career, eventually serving in both the House and Senate and was the unsuccessful Republican candidate for vice president in 1884. When he died two years later, Logan’s body laid in state in the rotunda of the United States Capitol, making him one of just 33 people to have received the honor. Today, Washington, D.C.’s Logan Circle and several townships across the country are named in honor of this champion of veterans and those killed in battle.

(2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or

(3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these.

While you enjoy your Memorial Day Weekend, please take a few moments to give thanks to those who gave the greatest sacrifice so those of us could live in freedom in this great country, the United States of America.

If you are able, save for them a place inside of you and save one backward glance when you are leaving for the places they can no longer go. Be not ashamed to say you loved them, though you may not have always. Take what they have left and what they have taught you with their dying and keep it with your own. And in that time when men decide and feel safe to call the war insane, take one moment to embrace those gentle heroes you left behind.—Major Michael Davis O’Donnell, January 1, 1970
_________________________________1Special Causes of Loss Form: War and Military Action Exclusion. IRMI (subscription required) https://www.irmi.com/online/cpi/ch005/cp10300917/b1f-war-and-military-action-exclusion.aspx

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/memorial-day-and-the-war-clause-in-property-insurance-polices/feed/0Does A Proof of Loss Have to Be Notarized? Join the Livestream Proof of Loss Discussion on Friday at 2PM ESThttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/does-a-proof-of-loss-have-to-be-notarized-join-the-livestream-proof-of-loss-discussion-on-friday-at-2pm-est/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/does-a-proof-of-loss-have-to-be-notarized-join-the-livestream-proof-of-loss-discussion-on-friday-at-2pm-est/#respondThu, 21 May 2020 10:00:36 +0000https://www.propertyinsurancecoveragelaw.com/?p=26662Continue Reading]]>Corey Harris

Corey Harris and I will be hosting the second discussion about Proofs Of Loss this Friday afternoon at 2 PM EST. Those viewers tuning in to the Livestream will also be invited to get our new Merlin Law Group educational ebook about Proofs of Loss.

I want to give a shout out to public adjuster Cal Spoon. Cal hosted an educational event for public adjusters and one of his students posted on Facebook that she learned that a notarized proof of loss was not required. Cal Spoon knows what states and what policies may require a notary signature. But, his student’s post lead me to this series discussing Proofs of Loss.

So, do proofs of loss have to be notarized? Read the following federal court decision:1

Plaintiffs have failed to meet the requirements for sworn statements or for unsworn statements under Section 1746. To execute a sworn statement correctly, plaintiffs were required to have their POL notarized. To correctly execute an unsworn statement, plaintiffs had to attest both that the facts contained in the POL were true and correct, and that their statements were made under penalty of perjury. Plaintiffs’ POL is not notarized, and it does not include a declaration that the contents of the POL are true under penalty of perjury. The POL states, ‘I hereby declare and attest that the information contained in this letter is true and correct to the best of my knowledge.’ The POL therefore does not meet the SFIP’s requirement that the statement be ‘sworn.’ SeeHagstotz v. Nationwide Mut. Ins. Co., No. 17-2491, 2018 WL 5005000 at *4 (D. N.J. Oct. 16, 2018) (holding that a POL must either be notarized or meet the requirements of 28 U.S.C. § 1746 to qualify as ‘sworn’ under the terms of the SFIP).

Ouch! Yes, in many circumstances, the proof of loss needs to be notarized. Most insurance company adjusters overlook this requirement and many states legally do not require it.

So, what is the Chip Merlin Rule? Safe is Better Than Sorry. If the policy requires a “sworn” proof of loss, make it sworn. If it requires a notary signature, go get it. What is the downside to doing so when the policy requires it?

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/does-a-proof-of-loss-have-to-be-notarized-join-the-livestream-proof-of-loss-discussion-on-friday-at-2pm-est/feed/0Replacement, Repair and Law & Ordinance Time Frames—Do Not Miss Tuesday at 2 With Chip For a Discussion About Often Overlooked Time Frameshttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/replacement-repair-and-law-ordinance-time-frames-do-not-miss-tuesday-at-2-with-chip-for-a-discussion-about-often-overlooked-time-frames/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/replacement-repair-and-law-ordinance-time-frames-do-not-miss-tuesday-at-2-with-chip-for-a-discussion-about-often-overlooked-time-frames/#respondTue, 19 May 2020 15:02:57 +0000https://www.propertyinsurancecoveragelaw.com/?p=26649Continue Reading]]>Mick Jagger sang that “time is on my side.” That is not true when it comes to insurance policies. At 2 PM EST today, Merlin Law Group Attorney Larry Bache and yours truly will discuss those important and often overlooked time frames for repair and replacement required under insurance policies.

This is the third discussion about “time traps” that prevent policyholders from recovering following a loss. We will recap those lessons and then quickly delve into the rules regarding replacement and repair.

I usually think of property insurance as the product which is supposed to provide prompt payment and be the financing mechanism for repair and replacement. Most policyholders want assurance about what the insurer will pay/finance. An IRMI article discusses this dilemma:

Most replacement cost policies require the insurer to pay actual cash value (ACV) once that value has been determined. They also require the policyholder to actually repair or replace before the difference between ACV and the full cost to repair or replace (the replacement cost value or RCV) is due and owing. Most insureds do not have the wherewithal to complete repairs without the proceeds of their property insurance policy. Most policyholders are unable and unwilling to begin a substantial repair project without the ACV payment and an agreement by the insurer as to the amount of RCV and that the insurer will pay it when due.1

This is an important post-loss topic – especially dealing with delays caused by adjustment actions or dispute resolution. Yet, it is often an overlooked part of the coverage analysis.

We have a great set of handouts on the topic and a PowerPoint presentation highlighting the important considerations while time is ticking following the loss.

]]>https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/replacement-repair-and-law-ordinance-time-frames-do-not-miss-tuesday-at-2-with-chip-for-a-discussion-about-often-overlooked-time-frames/feed/0Time Deadlines To Be Wary Of When Filing Property Insurance and Business Income Loss Claims—Do Not Miss Tuesday At 2 With Chip Merlinhttps://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/time-deadlines-to-be-wary-of-when-filing-property-insurance-and-business-income-loss-claims-do-not-miss-tuesday-at-2-with-chip-merlin/
https://www.propertyinsurancecoveragelaw.com/2020/05/articles/insurance/time-deadlines-to-be-wary-of-when-filing-property-insurance-and-business-income-loss-claims-do-not-miss-tuesday-at-2-with-chip-merlin/#respondMon, 11 May 2020 10:00:01 +0000https://www.propertyinsurancecoveragelaw.com/?p=26601Continue Reading]]>Insurance policies always have time deadlines to do something after a loss happens. The failure to follow these may prevent recovery. I will be discussing and answering questions about these policy time requirements over the next several weeks during our Tuesdays at 2 With Chip Merlin.

What are the primary time deadlines that policyholders have to be wary of? Here are the big four:

Notice of Loss

Proof of Loss

Repair and Replacement

Statutes of Limitation

There are other time considerations, but these are the “killers of coverage” in some jurisdictions and under some circumstances. Following a loss, every policyholder should know these dates, the rules in their particular state governing them, and how they can kill coverage.

Why did I place special emphasis on the rule in each state? Because analysis varies depending on the type of loss, policy language, and the statutes, regulations, and common law of each state. These are sometimes not the easiest rules to apply.

Often, insurance companies, acting in the utmost of good faith, do not enforce the rules even if they could avoid payment. I see this when reviewing files. Bravo to those insurers that allow the insurance product to do what it supposed to do—pay the claim benefits.

This sometimes leads to some policyholders, public adjusters, and contractors thinking that there must be a different rule or that insurers will not enforce the time rules. Then a denial occurs with a time deadline recited as the reason, and we are faced with determining if the rule truly applies so coverage can be afforded.

These time requirements can be legally complex in many states and deserve study so they are not missed and coverage benefits lost. I hope you can join us for the first of these sessions tomorrow at 2 PM EST.

On Friday, I will be starting a weekly topic just on proofs of loss with Merlin Law Group attorney, Corey Harris. Corey wrote a series of blogs a decade ago on various issues concerning proofs of loss. Proofs of loss are often misunderstood, and I recently posted on social media warning public adjusters not to tell policyholders that they do not have to file notarized proofs of loss. Just that one topic of a proof of loss is full of legal complexities which vary greatly between the states and depending on the type of loss. Each week we will cover specific topics about proofs of loss, which we hope to keep to 30 minutes every Friday.

Thought For The Day

Deadlines aren’t bad. They help you organize your time. They help you set priorities. They make you get going when you might not feel like it.—Harvey Mackay